Editor's note: Dr. Edith Bracho Sanchez, a primary care pediatrician at Columbia University Irving Medical Center in New York, hosts the American Academy of Pediatrics' Healthy Kids podcast for parents.
(CNN) -- Vaccine refusal is no longer always outright in pediatric clinics. An increasing number of parents are postponing vaccinating their children for various reasons, including waiting for the other parent to attend or wanting more time. But the result is the same: children leave the clinic without receiving their vaccines.
“We are not against vaccines, but we are waiting for the father to come.”
When the father comes for the next visit, he says: “I think the mother should be there when the vaccines are given.”
A parent might say, "We'll definitely vaccinate our child, but we're having a birthday party soon, and we don't want her to feel unwell."
Another agrees to be vaccinated, then leaves before the nurse returns with the vaccines, claiming that his child is “very upset,” even though he had been playing happily minutes before.
Vaccines have become a socially and politically charged issue, prompting some parents to avoid announcing their position, choosing postponement rather than outright rejection.
This is a worrying trend. In the 2025-2026 school year, 92.4% of U.S. kindergartners completed the recommended doses of the measles, mumps and rubella vaccine, down from 95.2% in the 2019-2020 school year. The gap may seem small, but it means that 280,000 children enrolled in schools without documents proving that they had completed the required doses.
As of early October 2026, the United States had recorded 4,080 confirmed cases of measles and two deaths, according to the US Centers for Disease Control and Control, compared to 2,289 cases and 3 deaths in 2025, and 285 cases and no deaths in 2024.
I, along with many of my pediatric colleagues, realized that convincing vocal opponents of vaccines was no longer enough. We also have to be better at dealing with those who say “not today,” which we are making great efforts to do.
When a parent tells me they will vaccinate their child at the next visit, I respect their decision, but I explain to them that waiting means their child will leave the clinic unprotected from a preventable disease.
I suggest setting a clear date when a parent says, “Maybe next time.” Saying, “We will do that later” expresses an intention, while saying, “We will return Tuesday at 3:30 p.m.,” turns it into a plan, and makes it easier to return to vaccinate the child without embarrassing or blaming the parents.
I now talk more with families about the diseases that vaccines are intended to prevent. Vaccines have been such a success that many parents today, and even young pediatricians, have not seen the effects of these diseases. Most parents have never seen an infant suffering from whooping cough or rotavirus, or a child hospitalized with measles complications.
When illness seems only a theoretical possibility, and claims about vaccine side effects are easy to find on social media, parents' assessment of the risks may be distorted. The recent outbreaks of measles remind us that these diseases have not disappeared, but rather the spread of many of them has decreased thanks to vaccines.
I also treat vaccinations as a normal part of preventive care. Instead of asking parents what they want to do, I tell them: “Today is the time for your child to receive these vaccines.”
We discuss the benefits and risks of vaccines, and families have the right to ask questions, but they reserve the final decision. But clear communication is essential in a world full of misinformation.
In complex discussions, I adjust my approach to each situation. If one parent needs to consult with the other, we contact them together. If they both need more time, make sure to provide them with reliable information and involve them in the following discussion.
She also involved the grandparents, and sometimes even watched clips on social media and read posts in chat groups to answer everyone's questions.
We need to make approval for vaccination as easy as possible, by improving access to vaccines, simplifying procedures, and devoting more time to answering parents’ questions and concerns.
The cases I see in the clinic make me wonder if there is a group of parents who actually support vaccines, but are postponing them. Understanding how to support these families requires more research and funding. Pediatricians also need to understand how parents make decisions about vaccines, and how these decisions change.
Ultimately, I don't care much whether parents describe themselves as pro-vaccine or anti-vaccine; viruses and bacteria don't care about these labels. What matters is protecting children from measles, mumps, rubella, influenza, chicken pox and other diseases, not labels. In order for every child to be protected, they must receive their vaccines today.
